Assessment
Your physiotherapist discusses your symptoms, goals, medical history and lifestyle, then completes a thorough assessment. Initial appointments are typically 45 to 60 minutes, so there is time to do it properly.
What We Treat
Shoulder Pain Treatment in London
Shoulder pain is patient about nothing. It wakes you at night, it stops you serving, lifting or reaching into the back seat, and it rarely settles on its own. We work out which structure is complaining and load it back to strength.
Overview
Understanding shoulder pain & rotator cuff
The shoulder trades stability for range. It is the most mobile joint you own, which is exactly why it is the one that gets irritable when the muscle around it cannot control that range.
Most shoulder pain we see falls into a handful of pictures:
- Rotator cuff pain and tears: from irritation through to full-thickness tears, with or without surgery.
- After rotator cuff repair: staged rehabilitation to your surgeon's protocol.
- Subacromial pain: pain on reaching overhead, often worse at night lying on that side.
- Frozen shoulder: progressive stiffness and loss of rotation, where knowing the stage changes the treatment entirely.
- Instability and dislocation: shoulders that have come out, or feel like they might.
- Overhead sport: tennis, padel, cricket, swimming and racket sport, where the shoulder is the engine.
Night pain and a shoulder that will not lift are the two things people leave longest and regret most. Stiffness sets in quickly and takes far longer to reverse than it took to develop.
Physiotherapy leads the plan. Shockwave therapy has a role in stubborn calcific and tendon-related shoulder pain, and soft tissue therapy restores tissue glide after surgery. Shoulder work overlaps with post-operative rehabilitation and sports injuries.
Excellent
From 4 five-star Google reviews
Source: Google
I first started using Tom last year to help relieve back pain, he has been extremely helpful and now he's supporting me with sprint and fitness training, whilst helping with any minor injuries. Can't recommend him and his team more highly.
I went to Tom with a shoulder injury that had not improved for several months. Tom is very knowledgeable and quickly identified the issue and put me on a course of exercises that, in conjunction with a couple more sessions, steadily resolved the problem. I would highly recommend him.
Parinita was brilliant! Identified my knee problem immediately, used a range of equipment and exercises not only to strengthen my knee, but to maintain it and improve my running long-term.
Excellent service! Sanchez is a true professional who helped me heal a previous injury. Highly recommend!
Shoulder physiotherapy can help to:
Get the diagnosis right first
Cuff, capsule, instability and referred neck pain all present as "my shoulder hurts" and all need different treatment. Initial appointments run 45 to 60 minutes because sorting out which one you have is the part that determines everything after it.
Sleep through the night again
Night pain is usually the first thing to improve and the thing people notice most. Settling the irritated tissue and changing how you load it during the day is what buys back the sleep, and it typically comes before the strength does.
Load the tendon properly
Rotator cuff tendons respond to progressive load, not rest. Our clinics sit inside gym facilities, so the weight your shoulder needs in the middle stage is available in the same building rather than left to a sheet of exercises at home.
Know where you are with a frozen shoulder
Adhesive capsulitis moves through stages, and the treatment that helps in the stiff stage makes the painful stage worse. We work out which stage you are in, treat accordingly, and give you an honest projection rather than a general one.
Return to overhead sport with confidence
Serving, bowling, swimming and throwing ask more of the shoulder than daily life ever does. Emma works with the British Tennis performance team, so overhead athletes are familiar ground, and the late stage of your rehab is built around your actual sport.
Rehabilitate a repair to protocol
Where you have had a cuff repair, we work to your surgeon's protocol and layer our own progression and testing on top. Full return to overhead sport is usually 6 to 9 months, and you get a projection for your procedure at the first appointment.
Why it happens
What causes shoulder pain & rotator cuff?
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Rotator cuff tendinopathy or tear, either gradual or after a specific lift or fall
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Subacromial pain from how the shoulder is loaded and controlled through range
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Frozen shoulder (adhesive capsulitis), sometimes with no clear trigger
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Dislocation or subluxation, and the instability that can follow
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Repetitive overhead load: serving, bowling, swimming, throwing and racket sport
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Calcific tendinopathy, where calcium deposits form within the tendon
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Referred pain from the neck presenting as shoulder pain
What happens at your first physio appointment?
Initial appointments are typically 45 to 60 minutes. You leave with a clear explanation of your condition, treatment recommendations, a report explaining it in simple language, and a personalised rehabilitation plan.
Follow-ups run 30 to 45 minutes, and we reassess at every visit rather than selling you a block of sessions up front.
A thorough, honest, and understandable explanation. Then the best treatment to get you back to a level of activity beyond your pre-injury status. If we can't get you better, we will recommend the world's leading healthcare professionals in London that can.
- Founded in 2015 by Tom Astley: 7 clinicians working across 3 clinics in Crouch End, Marylebone and Henley-on-Thames.
- Our team has successfully worked with local, national and international athletes at 6 major multi-sport events, from London 2012 to Gold Coast 2018, and we bring that expertise to everyone who enters our service.
- Rated 4.9 from 88 Google reviews; recognised by 5 major UK insurers, and self-funded patients book online with no GP referral.
Fees and insurance
Book directly online through Splose. Self-funded patients need no GP referral; if you are claiming through insurance, obtain prior authorisation before booking.
- Physiotherapy with Tom Astley: £85 initial consultation, £77 follow-up
- Sports and dance therapy with Laura Fornoni: £75 initial consultation, £70 follow-up
- Shockwave therapy: £230 for the initial consultation plus 3 sessions, then £80 per further treatment
- Running gait and performance reviews: £80 Base, £135 Intermediate, £185 Expert
- Recognised by Bupa, Cigna, Vitality, WPA and Simply Health
How physiotherapy works
from assessment to return to sport
Book today to get an assessment, advice, a report and a rehabilitation plan. We combine hands-on treatment with gym-based rehab to get you well, today, and we reassess at every visit.
Advice and report
A clear explanation of your condition and a report explaining it in simple language, alongside hands-on treatment: manual therapy, soft tissue techniques and joint mobilisation where they help.
Rehabilitation plan
Exercise rehabilitation tailored to your goals and condition, delivered through Track Rehab. Our clinics sit inside gym facilities, so the plan has the equipment and technology it actually needs.
Return
Structured programmes and return-to-sport testing before you go back, so you return safely and confidently. The goal is a level of activity beyond your pre-injury status, not just less pain.
What our physiotherapists treat
- Manual therapy and joint mobilisation
- Exercise rehabilitation through Track Rehab
- Dry needling for stubborn trigger points
- Shockwave therapy for chronic tendinopathy
- Sensor-based running gait analysis
- Sports massage, scar work and soft tissue therapy
- Women's health, Mummy MOT and postnatal rehabilitation
- Post-operative and ACL rehabilitation
- Return-to-sport testing
Treatment approach
How do we treat shoulder pain & rotator cuff?
Physiotherapy & Sports Therapy
From £75Assessment to establish which structure is involved and at what stage, then progressive loading to restore range, control and strength through the whole arc of movement.
See treatment detail →Shockwave Therapy
£230 for 3 sessionsFor stubborn calcific and tendon-related shoulder pain that has not responded to loading alone, delivered alongside rehabilitation rather than instead of it.
See treatment detail →Soft Tissue Therapy
Price on enquirySoft-tissue work around the shoulder girdle and, after surgery, scar mobilisation from around 6 to 8 weeks post-op to restore glide and range.
See treatment detail →FAQ
Frequently asked
questions
Why is my shoulder worse at night?
Night pain is common with rotator cuff and subacromial problems. Lying down changes the load through the tendon and removes the daytime distractions. It is one of the more reliable signs that a shoulder needs assessing rather than waiting out, so it is worth booking in.
Does a rotator cuff tear always need surgery?
No. Many partial tears do well with structured loading, and strength can improve substantially without repair. Larger tears, younger patients and heavy overhead demands more often go the surgical route. We assess it and give you an honest view, then refer where surgery is right.
How long does rehabilitation take after a cuff repair?
Around 6 to 9 months for a full return to overhead sport. Early rehab protects the repair and restores range, the middle stage rebuilds strength, and the late stage restores the specific overhead demand. We work to your surgeon's protocol and test you at each stage.
Is frozen shoulder just something I have to wait out?
Not quite. It does follow a natural course, but the stage you are in changes what helps. Pushing hard into range during the painful stage makes it worse, while the later stiff stage needs exactly that. Getting the stage right is most of the treatment.
Related What We Treat
Get Started
Book a physiotherapy appointment
in Crouch End, Marylebone or Henley.
Tom Astley Physiotherapy • Park Road Pools & Fitness, Crouch End, London N8 8JN
BookAppointments typically available within 1–2 weeks